Introduction
Background
Objectives
Material and methods
Study design and setting
Participants
Variables
Statistical methods
Results
Participants
Descriptive data
Patient data | % (n/N)a or Mean (SD)b | |
---|---|---|
All patients (N= 181) | ||
Age | 53.5 | (23.3) |
Sex (female) | 48.6 | (88/181) |
Diagnosis | ||
Rectal cancer | 44.2 | (80/181) |
Colon cancer | 7.2 | (13/181) |
Gynaecologic cancer | 7.7 | (14/181) |
Diverticulitis | 8.3 | (15/181) |
Inflammatory bowel disease | 3.3 | (6/181) |
Perforation | 5.0 | (9/181) |
Cystic fibrosis | 3.9 | (7/181) |
Other | 20.4 | (37/181) |
BMI (available in N= 179) | 22.1 | (5.33) |
< 18.5, underweight | 23.5 | (42/179) |
18.5–25.0, normal weight | 50.3 | (90/179) |
25.0–30.0, overweight | 19.6 | (35/179) |
30.0–35.0, class I obesity | 4.5 | (8/179) |
35.0–40.0, class II obesity | 2.2 | (4/179) |
> 40.0, class III obesity | 0 | (0/179) |
Non-smokers | 76.1 | (89/117) |
Non-drinkers | 65.3 | (77/118) |
Comorbidities | ||
Diabetes mellitus | 10.7 | (19/178) |
Cardiovascular disease (except arterial hypertension) | 9.0 | (16/178) |
Arterial hypertension | 23.0 | (31/178) |
Chronic kidney disease | 3.4 | (6/178) |
COPD | 5.6 | (10/178) |
Systemic steroid treatment | 2.8 | (5/178) |
Neoadjuvant oncological treatment | 57.5 | (46/80) |
History of abdominal wall hernia | 6.8 | (8/118) |
Laboratory parameters during hospitalisation | ||
CRP maximum (mg/dl) | 12.1 | (9.97) |
Haemoglobin minimum (g/l) | 103 | (20.20) |
Creatinine maximum (mg/dl) | 1.21 | (1.15) |
Estimated glomerular filtration rate (MDRD-IDMSc) | 72.8 | (51.48) |
Kidney injury in hospital (defined as eGFR < 60ml/min/1.73m2) | 31.8 | (57/179) |
Length of stay (days) | 21.5 | (42.72) |
Parastomal hernia | 5.0 | (9/181) |
Teaching operation (performed by surgical trainee) | 26.6 | (47/177) |
Type of stoma | ||
Ileostoma | 92.2 | (166/181) |
Colostoma | 7.8 | (15/181) |
Terminal ostomy | 14.9 | (27/181) |
Loop ostomy | 85.1 | (154/181) |
Outcome data
All patients with follow-up (N = 140) | Subgroup: patients with ileostomy reversal and oncologic follow-up for rectal cancer (N = 71) | |
---|---|---|
Follow-up (weeks since stoma reversal) | ||
Mean (SD) | 140.1 (92.22) | 160.0 (96.59) |
Median (P25–P75) | 137.9 (61–214) | 142.6 (70–227) |
IH at stoma reversal site | ||
Incidence of stoma IH (%) | 15.7 (22/140) | 16.9 (12/71) |
Median time to stoma IH (P25–75) | 31.4 (8.8–57.1) | 28.6 (7.2–61.2) |
IH at any other surgical access site | ||
Incidence of other IH (%) | 18.6 (26/140) | 29.6 (21/71) |
Hernia repair | ||
Incidence of hernia operations (%) | 26.8 (11/41) | 23.1 (6/26) |
% (n/N)a or median (P25–P75) | |
---|---|
Midline incisional herniab | |
M1 subxiphoidal | 0 (0/41) |
M2 epigastric | 43.9 (18/41) |
M3 umbilical | 75.6 (31/41) |
M4 infraumbilical | 14.6 (6/41) |
M5 suprapubic | 0 (0/41) |
Lateral incisional hernia | 0 |
Recurrent incisional hernia | 0 |
Measurements | |
Length (cm) | 4 (1.9–8) |
Width (cm) | 3.65 (1.7–5) |
Width classification | |
W1 < 4 cm | 53.6 (22/41) |
W2 ≥ 4–10 cm | 43.9 (18/41) |
W3 ≥ 10 cm | 2.4 (1/41) |
Risk factors
Variable | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|
Prevalence (%) | Odds ratio (95% confidence interval) | Fisher’s exact test p value | Binary logistic regression p valueb | |
Age ≥ 65 vs. < 65 years | 45.7% | 1.72 (0.79–3.75) | 0.128 | 0.496 |
Sex (female vs. male) | 45.0% | 0.27 (0.09–0.76) | 0.005 | 0.030 |
Body mass index ≥ 25 vs. < 25 | 26.3% | 4.93 (2.20–10.99) | < 0.001 | 0.003 |
Length of Stay (days) ≥ 12 vs. < 12 | 40.7% | 1.21 (0.56–2.62) | 0.395 | – |
UICC stage ≥ III vs. < III | 40.0% | 1.50 (0.63–3.59) | 0.263 | – |
Smoking | 26.1% | 0.22 (0.03–1.58) | 0.070 | – |
Drinking | 36% | 1.30 (0.49–3.43) | 0.402 | – |
Laboratory parameters during hospitalisation | ||||
CRP maximum ≥ 15 vs. < 15 (mg/dl) | 31.4% | 1.02 (0.45–2.32) | 0.574 | – |
Haemoglobin minimum < 90 vs. ≥ 90 (g/l) | 26.4% | 0.44 (0.14–1.40) | 0.108 | 0.607 |
Estimated glomerular filtration rate (MDRD-IDMSa) minimum < 60 vs. ≥ 60 (ml/min/1.73 m2) | 39.8% | 0.93 (0.42–2.08) | 0.531 | – |
Comorbidities | ||||
Diabetes mellitus | 9.4% | 1.52 (0.52–4.44) | 0.343 | – |
Cardiovascular disease (except arterial hypertension) | 8.7% | 1.77 (0.48–6.49) | 0.603 | – |
Arterial hypertension | 23.9% | 2.65 (1.26–5.59) | 0.013 | 0.030 |
Hypertensive blood pressure (maximum systolic) during hospital stay (≥ 160 vs. < 160 mmHg) | 25.5% | 2.55 (1.04–6.29) | 0.047 | – |
Systemic steroid treatment | 3.6% | 1.27 (0.21–7.63) | 0.586 | – |
Neoadjuvant treatment | 31.2% | 1.53 (0.71–3.30) | 0.203 | – |
Parastomal hernia | 5.0% | 5.59 (2.93–10.64) | 0.001 | 0.002 |
IH at other surgical access sites | 18.6% | 3.04 (1.46–6.33) | 0.007 | 0.418 |
History of abdominal wall hernia | 7.5% | 3.36 (1.21–9.26) | 0.067 | 0.431 |
Teaching operation (performed by surgical trainee) | 26.6% | 1.23 (0.48–3.14) | 0.442 | – |